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骨关节炎

Osteoarthritis.

作者信息

Swedberg J A, Steinbauer J R

机构信息

University of Wyoming Family Practice Residency Program-Casper, Casper.

出版信息

Am Fam Physician. 1992 Feb;45(2):557-68.

PMID:1739042
Abstract

Osteoarthritis is a frequent cause of physical impairment in the elderly. The disease has a slow, progressive course that ends with joint failure and subsequent disability. The hands and the large weight-bearing joints are most commonly affected. The cause of osteoarthritis is unknown. The strongest risk factor is age, but age alone does not cause the disease. Clinically, osteoarthritis is manifested by joint pain and stiffness. Radiographs reveal joint space narrowing, subchondral sclerosis, osteophytes and, later, subchondral cysts and intra-articular osseous bodies. Biochemically, the cartilage in osteoarthritis differs from normal cartilage in elderly patients. The goals of treatment are to control pain, maintain function through strengthening and range-of-motion exercises, protect the joint and limit iatrogenic injury by selecting treatment options that minimize complications. Even when cure is not possible, appropriate medical care can improve the patient's functioning and well-being.

摘要

骨关节炎是老年人身体功能受损的常见原因。该病病程缓慢且呈进行性发展,最终导致关节功能衰竭及随后的残疾。手部和大的负重关节最常受累。骨关节炎的病因尚不清楚。最强的危险因素是年龄,但仅年龄本身并不会引发该病。临床上,骨关节炎表现为关节疼痛和僵硬。X线片显示关节间隙变窄、软骨下硬化、骨赘形成,后期还会出现软骨下囊肿和关节内骨性小体。从生化角度来看,骨关节炎患者的软骨与老年患者的正常软骨有所不同。治疗目标是控制疼痛,通过强化锻炼和关节活动度练习维持功能,保护关节,并通过选择使并发症最小化的治疗方案来限制医源性损伤。即使无法治愈,适当的医疗护理也可改善患者的功能和健康状况。

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